What are the treatment methods after a five-paced viper bite?
The venom of the five-paced viper is a hemotoxin, also called fire poison in traditional Chinese medicine. After being bitten, it manifests as uncontrollable bleeding that generally cannot be stopped with pressure bandaging, and can cause systemic poisoning with widespread bleeding throughout the body. Locally, symptoms such as swelling, pain, tenderness, and ulcers extending upward along the affected limb may also appear. In severe cases, it can cause necrosis of the affected limb. Once necrosis occurs in the affected limb, it is difficult to heal and will severely affect the function of the limb, leading to a decline in the patient's quality of life. Clinically, various complications or sequelae are also common, such as acute cardiac and renal insufficiency, shock, DIC, and even multiple organ failure, endangering the patient's life.
Identify the venomous snake
After being bitten by a five-paced viper, it is important to promptly take effective measures to treat the wound and send the patient to the hospital for emergency care as soon as possible. The patient should stay calm and must not panic or run, in order to slow down the body's absorption of the snake venom and the speed at which the venom spreads through the body, and to reduce systemic reactions. The patient should sit down on the spot or adopt a semi-reclining position, keep the affected limb as still as possible, and keep the wound below heart level while treating the wound and providing first aid. Even if it is unclear whether the bite was from a venomous five-paced viper, you must never wait for poisoning symptoms to appear and must treat it as a venomous snake bite to avoid delaying treatment. Remember the type or characteristics of the snake and the appearance of the wound, and inform the emergency medical personnel in detail so that they can provide timely and correct treatment. It should also be noted that the five-paced viper is not very active and crawls slowly; even if it bites someone, it will not crawl far, so guard against being bitten a second time.
Ligate the wound
After a venomous snake bite, a ligature should immediately be applied 5-10 cm proximal to the wound (the side closer to the heart). If no cord is available, find some green vines to bind the area where blood vessels flow. It should be tied firmly but not too tightly; the degree should be based on the principle of blocking venous blood and lymphatic return without hindering arterial flow. A slip knot may be left for easy loosening, so as to prevent the snake venom from spreading toward the heart and to slow the speed of spread. Afterward, loosen it once every 15-30 minutes, each time for about 30 seconds to 1 minute. If the swelling at the wound expands rapidly, check whether it is tied too tightly; the tying time should be shortened and the loosening time increased to avoid ischemic necrosis of the limb. The ligature can be removed after effective local detoxification of the wound or systemic application of antivenom serum. If more than 12 hours have passed since the bite, ligation is not needed.
Rinse the wound
If fangs are found, they should be removed immediately with tweezers. After local rinsing, perform routine disinfection and use 0.5% procaine for local block anesthesia. After the wound is ligated, it should be rinsed immediately. The rinsing solution can be normal saline, hydrogen peroxide, cold tea, soapy water, 0.1% potassium permanganate solution, etc. If none of these liquids are available in the field, the affected limb can be placed in a stream or pond to rinse. Do not rub the wound; pat it gently with a cloth to dry it. If the patient needs to be moved, carry the patient rather than letting the patient walk.
Debride and drain the poison
Generally, after a venomous snake bite, the wound should be incised. Use a small knife, a three-edged needle, or another clean sharp instrument (preferably sterilized) to make a longitudinal or "“+”"-shaped incision along the fang marks of the wound, about 1-2 cm long and deep to the subdermis, but not too deep, with the principle of cutting through the skin between the two fang marks. However, if bitten by a five-paced viper or a viper, the wound will bleed continuously, so no incision is needed. In addition, if more than 24 hours have passed since the bite or the wound has already become necrotic, no incision is needed either. (After incision) the wound should be cleaned immediately, using both hands to repeatedly push and squeeze from the proximal end toward the distal end and from the surrounding area toward the wound for about 15 minutes to expel the poisoned blood. A breast pump or cupping jar can also be used to suction out the venom. Do not suck out the blood with your mouth, as the toxin may be transmitted through the oral cavity; especially if there are ulcers or cavities in the mouth, never suck out the poison. If venom accidentally enters the mouth, spit it out immediately and rinse the mouth with liquor or clean water. Depending on the condition of the injury, this may be repeated after an interval of 12-24 hours.